Nirmohamananushayo nirashah punarvasurgyanatpovishalah.
Kaleagniveshaya sahetulinganuvacha mehanshamanam cha tesham. (Charak Samhita/chikitsa sthana/6/3)
Once upon a time Punarvasu devoid of confusion, conceit, anger and attachment and great in knowledge and penance, said to Agnikvesha the types of prameha with etiology and symptoms along with its treatment.
Asyasukham swapnasukham dadhini gramyodakanuprasah payansi.
Navannapanam gudavaikrutam cha pramehahetuh kaphakrutacha sarvam (Charak Samhita/chikitsa sthana/6/4)
Idle sitting, oversleep, excessive use of curd, meat soup of the domestic, aquatic and marshy animals and milk; new cereals and drinks, products of jaggery and all other kapha-promoting regimens are etiological factors of prameha.
Medascha mamsam cha sharirajam cha kledam kapho yastigatam pradushya.
Karoti mehan samudirnamushnaistaneva pittam paridushya chapi. (5)
Kshineshu dosheshvavakrushya vasto dhatun pramehananilah karoti.
Dosho hi basti samupetya mutam sandushya mehanjanyedyathasvam. (Charak Samhita/chikitsa sthana/6/6)
Kapha causes pramehas by affecting medas (lipid metabolism), muscles and body fluid situated in urinary bladder. Pitta aggravated by hot things causes the same by affecting the above entities. Vayu, on relative diminution of other two doshas, draws on the dhatus in urinary bladder and thus causes pramehas. Dosha produces respective types of prameha by reaching the urinary bladder and affecting the urine.
Sadhyah kaphotha dasha, pittaja shat yapyah, na sadhyah pavanaschatushkah.
Samakriyatvadvishamkriyatvanmahatyayatvascha yathakramam te. (Charak Samhita/chikitsa sthana/6/7)
Ten types of kaphaj prameha, six types of pittaj prameha and four types of vatika prameha are curable, maintainable and incurable due to similarity of management, dissimilarity of the same and severity of complications respectively.
Kaphah sapittah pavanascha dosha medo astrashukrambuvasalasikah.
Majja rasaujah pishitam cha dushyah pramehinam, vinshatireva mehah. (Charak Samhita/chikitsa sthana/6/8)
In (pathogenesis of) pramehas, doshas are kapha, pitta and vata and dushyas are medas, blood, semen, fluid, muscle-fat, lasika  (lymph), majja (marrow), rasa, ojas and muscles. Prameha has twenty types.
Jalopamam chekshurasopamam va ghanam ghanam chopari viprasannam.
Shuklam sashukram shishiram shanairva laleva va valukaya yutam va. (9)
Vidyat pramehan kaphajan dashaitan ksharopamam kalamathapi nilam.
Haridramanjishthamathapi raktametan pramehan shadushanti pittat. (10)
Majgyaujasa va vasayanvitam  va lasikaya va satatam vibadham.
Chaturvidham mutrayatiha vatachesheshu dhatushvapakarshiteshu. (Charak Samhita/chikitsa sthana/6/11)
The ten types of kaphaja prameha are as follows: where the urine is (1) watery, (2) like sugarcane juice, (3) viscous, (4) having solid precipitate, (5) white, (6) with semen, (7) cold, (8) with sloe impulse, (9) saliva-like, (10) with gravels.
The types of pittaja prameha are as follows: wherein the urine is (1) like alkali, (2) black, (3) blue, (4) yellow with turmeric, (5) light red like manjishtha, (6) deep red.
Due to vata, when the other dhatus are diminished the patient passes urine of four types – (1) with majja, (2) with ojas, (3) with vasa, (4) with lasika.
Varne rasam sparshamathapi gandham yathaswadosham bhajate pramehah.
Shyavaruno vatakrutah sashulo majjadisadgunyamupaityasadhyah. (12)
Swedoangagandhah shithilangata cha shayyasana swapnasukhe ratischa.
Hrunnetrajivhathashravanopadeho ghanangata keshanakhativruddhi. (13)
Shitapriyatvam galatlushosho madhuryamase karapadadaha.
Bhavishyato mehagadasya rupam mutre abhidhavanti pipilikascha. (Charak Samhita/chikitsa sthana/6/14)
Prameha acquires the colour, taste, touch and smell according to the respective dosha. Prameha caused by vata which is associated with pain, has blackish or reddish urine and similarity with majja, etc is incurable.
Sweating, foul smell in body, slackness in body, liking for comfort in lying, sitting and sleeping; smearing in heart, eyes, tongue and ears, heaviness in body parts(overweight), excessive increase of hairs and nails, liking for cold, dryness in throat and palate, sweetness in mouth, burning sensation in hands and feet – these are the premonitory symptoms of prameha. Apart from these, ants also rush towards the urine (of the person).
Sthulah pramehi balavanihaikah krushastathaikah paridurbalascha.
Sabruhanam tatra krushasya karye sashodhanam doshabaladhikasya. (15)
Snigdhasya yoga vividhah prayojyah kalpopadishta malashodhanaya.
Urdhwe tatha adhascha male apanite meheshu santarpaneva karyam. (16)
Gulmah kshayo mehanbastishulam mutragrahaschapyapatarpanam.
Pramehinah syuhu, paritarpanani karyani tasya prasamikshya vanhim. (Charak Samhita/chikitsa sthana/6/17)
One type of patient of prameha is obese and strong while the other one is lean and weak. Of these, promotive treatment should be given to the lean and evacuation in case of patients having abundance of dosha and strength. After unction, various formulations for evacuation mentioned in kalpasthana should be administered. After elimination of excreta from upward and downward passages, saturation therapy should be applied in prameha because by de-saturation the patient is affected with gulma, wasting, pain in penis and bladder and obstruction in urine, but the measures for saturation should be applied taking power of digestion into consideration.
Sanshodhanam narhati yah pramehi tasya kriya sanshamano prayojya.
Manthah Kashaya yavachurnalehah pramehashantyelaghavascha bhakshyah. (18)
Ye vishkira ye pratuda vidangastesham rasairjangalairjarmanogyehi.
Yavaudanam rukshamathapi vatyamadyata sasaktunapi chapyayushan. (19)
Mudgadiyushairatha tiktashakaihi puranashalyodanamadadita.
Dantinguditailayutam prameho tathaatasisarshapatailayuktam. (20)
Sashahtikam syatadhrunadhanyamannam yavapradhanastu bhavet pramehi.
Yavasya bhakshyan vividhostathadyat kaphapramehi madhusamprayuktan. (21)
Nishisthatanam triphalakashaye syustarpanah kshaudrayuta yavanam.
Tan sidhuyuktan prapibet pramehi prayogikanmehavadharthameva.
Ye shleshmamehe vihitah kashayastairbhavitanam cha pruthagyavanama.
Saktunapupan sagudan sadhanan bhakshyanstathaanyana vividhascha khadet. (23)
Kharashvagohansaprushadbhrutanam tatha yavanam vividhascha bhaksyah.
Deyastatha venuyava yavanam kalpena godhumamayascha bhakshyah. (Charak Samhita/chikitsa sthana/6/24)
The patient of prameha who is not fit for evacuation should be subjected to pacificatory management for alleviation of the disease such as mantha (churned drink), extracts, linctus made of barley powder and light edibles. He should eat rough food articles such as boiled barley, barley cakes, flour of parched grains and apupa(a dietary preparation) with palatable meat soup of wild birds particularly gallinaceous and peckers. He should take old shali rice with soup of mudga etc. and bitter vegetables added with oil of danti and ingudi or linseed and mustard. In cereals, he should use shashtika and wild rice. The diet of the patient of prameha should consist mainly of barley. One suffering from kaphaja prameha should eat various preparations of barley added with honey. Barley grain dipped in decoction of triphala for the whole night make a saturating foot taken with honey. The patient may also take them regularly mixed with vinegar for alleviation of prameha. He should use flour of parched grains, bolus, parched grains and other various edibles made of barley impregnated with decoctions of drugs prescribed in (the treatment of) kaphaja prameha. (for non-vegetarians) various preparations of barley mixed with the meat of ass, horse, bull, swan and spotted deer should be prescribed. The seeds of bamboo and wheat may also be used in forms similar to those of barley.
Sanshodhanollekhananghanani kale prayuktani kaphapramehan.
Jayanti pittaprabhavan virekah santarpanah sanshamano vidhischa. (Charak Samhita/chikitsa sthana/6/25)
Evacuation, emesis and lightening applied in time overcome the kaphaja pramehas. Likewise, pugation, saturation and pacificatory measures subdue the pattika prameha.
Darvi suravham triphalam samustam kashayamutkhatya pibet pramehi.
Kshaudren yuktamathava haridram pibedrasenamalakiphalanam. (26)
Haritakikatphalamustalodhram pathavidangarjundhanvascha.
Ubhe haridre tagaram vidangam kadambashalarjunadipyakascha. (27)
Darvi vidanga khadiro dhavascha surahvakushtaguruchandanani.
Darviagnimanthau triphala sapatha patha cha murva cha tatha shvadanshtra. (28)
Yavanyushiranyabhayaguduchichavyabhayachitrakasaptaparnah.
Padaihi kashayah kaphamehinam te dashopadishta madusamprayuktah. (29)
Ushiralodhranjanachandananaptushiramustamalakabhayanam.
Patolanimbamalakamrutanam mustabhayapadmakavrukshakanam. (30)
Lodhrambukaliyakadhatakinam nimbarjunamranishotpalanam.
Shirishsarjarjunakesharam priyangupadmotpalakinshukanam. (31)
Ashwathapathasanavetasanam katankateryutpalamustakanam.
Paittaeshu meheshu dash pradishtah padaihi kashaya madhusamprayujtah. (32)
Sarveshu meheshu matau tu purvo kashayayogau vihitastu sarve.
Manthasya pane yavabhavanayam syurbhojane panavidhau pruthak cha. (33)
Siddhani tailani ghrutani chaiva deyani meheshwanilatmakeshu.
Medah kaphaschaiva kashayayogaihi snehaischa vayuhu shamameti tesham. (Charak Samhita/chikitsa sthana/6/34)
The patients of prameha should take decoction of daruharidra, devadaru, triphala and musta or he should take the powder of haridra mixed with honey along with the juice of amalaki fruits. The following ten decoctions added with honey are prescribed for kaphaja prameha such as 1) haritaki, katphala, musta and lodhra. 2) patha, vidanga, arjuna and dhanvana. 3) both haridras (haridra and daruharidra), tagara and vidanga. 4) kadamba, shala, arjuna and yavani. 5) daruharidra, vidanga, khadira and dhava. 6) devadaru, kushtha, aguru and Chandana. 7) daruharidra, agnimantha, triphala and patha. 8) patha, murva and gokshura. 9) yavani, ushira, haritaki and guduchi. 10) chavya, haritaki, chitraka and saptaparna.
Likewise, in paittika types the following ten decoctions added with honey are prescribed such as (1) ushira, lodhra, arjuna and Chandana. (2) ushira,musta, amalaka and abhaya. (3) patola, nimba, amalaki and guduchi. (4) musta, haritaki, padmaka and kutaja. (5) lodhra, hribera, kaliyaka and dhataki. (6) nimba, arjuna, amrataka and nagakeshara. (7) shirish, sarja, arjuna and nagakeshara. (8) priyangu, kamala, utpala and palash powder. (9) ashwattha, patha, asana and vetasa. (10) daruharidra, utpala and mustaka.
The above formulations of decoctions are useful in all types prameha. They all may be used in the form of mantha, impregnation of barley, food, drinks or alone. In vatika types of prameha oils and ghrutas cooked with these decoctions – should be given. Here the drugs of decoctions diminish medas and kapha and, on the other hand, the unction pacifies vayu.
Kampillasaptachhadashalajani baibhitarauhitakkautajani.
Kapitthapushpani cha churnitani kshaudrena lihyat kaphapittamehi.
Pibedrasenamalakasya chapi kalkikrutanyakshasamani kale.
Jirne cha bhunjita puranamannam mehi rasairjangalajairmanogyehi. (Charak Samhita/chikitsa sthana/6/36)
One suffering from prameha caused by kapha and pitta should take powder of the flowers of kampillak, saptachhada, shala, bibhitaka, rohitaka, kutaja and kapittha. Â These may also be taken as paste in the dose of 10 gm, along with amalaki juice in time. After the drug is digested, he should take food of old cereals along with decoctions meat-soup of wild animals.
Drushtvanubandha pavanat kaphasya pittasya va snehavidhirvikalpyah.
Tailam kaphe syat swakashayasiddham pitte ghrutam pittaharaihi kashayaihi. (37)
Trikantakashmantakasomavalkairabhallatakaihi sativishaihi salodhraihi.
Vachapatolarjunanimbamustaihiharidraya padmakadipyakaischa. (38)
Manjishthaya chaguruchandanaischa sarvaihi samastaihi kaphavatajeshu.
Meheshu tailam vipached, ghrutam tu paitteshu, mishram trishu lakshaneshu. (39)
Phalatrikam darunisham vishala musta cha nikwathya nisha sakalkam.
Pibet kashayam madhusamprayuktam sarvaprameheshu samudhateshu. (Charak Samhita/chikitsa sthana/6/40)
If there is association of vayu with kapha or pitta then unction should be applied. For this oil cooked with its own (anti- kapha) decoction in kapha and ghruta cooked with anti-pitta decoctions in pitta is useful.
Gokshura, ashmantaka, somavalka, bhallataka, ativisha, lodhra, vacha, patola, arjuna, nimba, musta, haridra, padmaka, yavani, manjishtha, aguru, chandana- with these drugs collectively oil should be cooked for kapha-vataja pramehas, ghruta for pittaj prameha and both mixed in tridoshaj.
Decoction of triphala, daruharidra, vishala, musta and haridra with its paste added with honey should be taken in all aggravated pramehas.
Lodhram shatim pushkarmulamelam murva vidanga triphalam yamanim.
Chavyam priyangu kramukam vishalam kirattiktam katukarohinim cha. (41)
Bharangi natam chitrakpippalinam mulam sakushthativisham sapatham.
Kalingakan kesharamindriyasavham nakham sapatram maricham plavam cha. (42)
Droneambhasah karshasamani paktva pute chaturbhagajalavasheshe.
Raseardhabhagam madhunah pradaya paksham nirdheyo ghrutabhajanasthah. (43)
Madhvasavoayam kaphapittamehan kshipram nihantyadidwipalaprayogata.
Pandvamayarshosyaruchi grahanya dosham kilasam vividham cha kushtham. (Charak Samhita/chikitsa sthana/6/44)
                                           (Iti Madhvasava)
Lodhra, shati, pushkaramula, ela, murva, vidanga, triphala, yavani, chavya, priyangu, kramuka, vishala, kirattikta, katurohini, bharangi, tagara, chitraka(root), pippalimula, kushtha, ativisha, patha, indrayava, nagakeshara, indravaruni, nakha, patra, maricha and plava each 10-gm. should be boiled in water 10.24 liters remaining to 1/4th. This should be filtered and added with half quantity of honey and kept in ghee smeared vessel for a fortnight. This formulation named ‘Madhvasav’ taken in the dose of 80 ml. alleviates kaphaj and pittaj pramehas quickly. It is also efficacious in anaemia, piles, anorexia, grahaniroga, leukoderma and various types of leprosy.
Kwathah sa evashtapalam cha dantya bhallatakanam cha chatushpalam syat.
Sitopala twashtapala visheshah kshaudram cha tavat pruthagasavau tau. (Charak Samhita/chikitsa sthana/6/45)
The above decoction added with danti 320 gm. or bhallataka 160 gm., sugar candy 320 gm and honey in the same quantity make two separate asavas (dantyasava and bhallatakasava).
Sarodakam vatha kushodakam va madhudakam va triphalarasam va.
Sidhum pibedva nigadam pramehi madhvikgryam chirasansthitam va. (46)
Mamsani shulyanki mrugadwijanam khadedyavanam vividhascha bhakshyan.
Sanshodhanarishtakashayalehehi santarpanothaya shamayet pramehan. (47)
Bhrushtan yavana bhakshayatah prayogachhushkascha saktunna bhavanti mehah.
Shwitram cha kruchram kaphajam cha kushtham tathaiva mudgamalkaprayogat. (Charak Samhita/chikitsa sthana/6/48)
One suffering from prameha should drink water processed with the drugs of shalsaradi group, kusha, honey water, triphala water, undamaged sidhu or old madhvika of good type. He should eat roasted meat of animals and birds and various preparations of barley. Pramehas caused by over-saturation should be pacified with the administration of evacuation, arishtas, decoctions and linctus.
Pramehas do not stand if one takes parched barley and dry parched grain flour regularly. Likewise, one becomes free from obstinate leukoderma and kaphaja leprosy by the regular use of green gram and amalaka.
Santarpanotheshu gadeshu yoga medasvinam ye cha mayopadishtah.
Virukshanarthe kaphapittajeshu siddhah prameshvapi te prayojyah. (Charak Samhita/chikitsa sthana/6/49)
The formulations mentioned by me for obesity in the context of diseases caused by over-saturation (Su 23) may also be used for roughening in kaphaja and pittaj pramehas.
